Preparatory Exercises for Locomotion Training

 

Bridging

• introduces weight bearing through the feet

• trains hip extension with knee flexion (requisite for gait)

 

Quadruped

• allows weight bearing through multiple joints
• inhibits spasticity in quadriceps and finger flexors
• rocking and weight shifting can be used to increase ROM, decrease spasticity, and increase trunk endurance in trunk and cervical extensors
• modifications and progressions:
• quadriped over ball/bolster: allows for partial weight-bearing in trunk http://www.whcenter.org/body.cfm?id=556940
• reaching in quadriped creeping
• functional activity: fall recovery and floor to stand requires motor control and planning from quadriped position

https://www.hep2go.com/exercise_editor.php?exId=342&userRef=okqdclggnism

 Test question

  

 

Sitting

• short sitting: hips and knees are flexed with feet flat on floor
• long sitting: hips are flexed and knees are extended on supporting surface( dependent on hamstring length)
• includes weight shifting and scooting in sitting, with and without UE support
• progressions
• feet unsupported
• unstable surface (gym ball, balance disc/board)
• seated push ups are functional activities for SCI/tetraplegia conditions
• therapy balls can increase proprioceptive input and dynamic control on the involved side. http://www.thera-bandacademy.com/exercises/showroutine.asp?erID=46&disease=12&t=9%3A09%3A07+PM
• http://strozpt.com/Stroz_PT/Balance_&_Vertigo_Rehabilitation.html

Sit to stand

• Forward weight shift activities increase motor control in trunk and in LEs to allow for weight transition.
• Partial sit to stand with UEs supported on mat table

 http://www.lynden-hill-clinic.co.uk/html/healthcare/strokes_CVA.htm

Kneeling

• Reinforces hip extension with knee flexion (ambulation pre-req)

 

• Half-kneeling: stabilization emphasis is on the posterior limb: allows for distal control of front leg and proximal control of back leg

Video Of Half-Kneeling Dynamic Activity

 

Modified Plantigrade

• Weight bearing on all extremities increases stability offered from trunk and facilitates knee extension

 

Standing

• Parallel bar progressions allow for B UE weight bearing in functional positions for transition to assistive device
• Anterior-posterior and anterior-lateral, posterior-lateral weight shifting with and without UE support for pre-gait sequencing
• Integrate weight-bearing patterns or restrictions as needed depending on the patient case

 http://www.lynden-hill-clinic.co.uk/html/healthcare/strokes_CVA.htm

toc | return to top | previous page | next page